Biotin, also known as vitamin B7, is a frequent visitor in various nutritional supplements and health foods. However, in recent years, the interference of biotin to laboratory detection has been repeatedly emphasized and mentioned. Some important detection indicators will be seriously disturbed by biotin, resulting in data inaccuracy, and even cases of patient death due to numerical inaccuracy. Moreover, with the deepening of research, new projects are constantly included in this disturbed queue.
Troponin: starting from the safety warning issued by FDA
The U.S. Food and Drug Administration (FDA) issued a safety warning in 2017 to remind clinical and laboratory workers that biotin, which often appears in nutritional supplements, can significantly interfere with some laboratory test items and lead to incorrect results. In the warning, FDA specifically pointed out that the interference of troponin and biotin will lead to too high or too low results, especially the phenomenon of too low test results, which needs special attention.
Troponin is one of the important clinical biomarkers, which is often used to assist in the diagnosis of heart attack. When the troponin level shows a lower value than the real level due to interference, it is easy to cause patients at risk of myocardial infarction and heart failure to delay the best treatment opportunity and cause serious consequences.
The awareness rate of doctors and patients is worrying. How many test results are disturbed in the real world?
Facing such a significant risk, the actual clinical situation is not optimistic.
A survey shows that although more than half of doctors know that biotin will cause serious interference with troponin (58.6%) and thyroid function related tests (62.5%), few clinical workers know the effect of biotin on 25-OH vitamin D, β- Interaction of serological tests for human chorionic gonadotropin (7%), hepatitis (2.3%) or HIV (1.6%). Nearly a quarter (19.5%) were completely unaware of the interference of biotin on serological testing.
Even knowing this risk of interference, nearly half (45.9%) of clinical workers reported that they did not recommend stopping taking biotin before patients underwent laboratory tests. Among patients, the awareness rate of this problem is less than one tenth, and 93.4% of patients do not know the FDA warning. Moreover, although most patients had blood tests during biotin Administration (56.2%), only 1.3% reported that their doctors asked questions about biotin administration.
As a relatively safe nutritional supplement, biotin (vitamin B7) is often recommended to patients by doctors. In some departments, such as dermatology, nearly half (43.9%) of doctors recommend patients to supplement biotin to help solve nail or hair problems.
Therefore, we cannot estimate how many disturbed detection results exist in the real world.
New projects are constantly included in the list of interference risks
In the 1st issue of Scandinavian Journal of clinical and laboratory investigation in 2022, researchers from Denmark proposed some new indicators that may be disturbed by biotin. The article pointed out that the determination of aldosterone and renin levels showed a large amount of biotin interference in a dose-dependent manner. Among them, the bias of aldosterone was as high as + 3484%, and the bias of renin was as high as - 98%. The results of insulin-like growth factor-1 (IGF-1), growth hormone (GH) and bone alkaline phosphatase (BAP) were usually less affected by the addition of biotin, and significant bias was observed only when the concentration of biotin was very high.
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